Intelligent pill box to improve medical adherence in elderly with hypertension : a randomized controlled trial

Abstract

Background: Antihypertension medical adherence is important for controlling blood pressure in hypertension patients. Adherence to antihypertension medication among elderly Thai persons in the rural area is low, which contributes to uncontrolled blood pressure.

Objective: To examine whether an intreated education program and innovative pill box improves adherence to medications and to improve controlling blood pressure among Thai elderly persons with hypertension.

Methods: A randomized controlled trial. 200 elderly persons with hypertension who received at least one hypertension medication, at least once daily, were randomized into two groups. One group received the usual education program (control group) and the second group (intervention group) received education program and a Thai Intelligent Pill Box. Intervention continued for three months. The perception and satisfaction of using this pillbox was explored and reported in this study. Intention to treat analyses using t- test and repeat ANOVA to compare the difference between two groups.

Result: Antihypertension medication adherence after three months was statistically significant different between the intervention and control group. Intervention group showed adherence higher than in the control group; mean difference 4.72 (95% CI ;0.61 to 8.85), p-value <0.025). Systolic blood pressure was no different between two groups while diastolic blood pressure was statistically significant different between two group at three months post intervention. Participant’s perception and satisfaction on functionality and features, as well as the design and size, were positive among participants.

Conclusion: This randomized controlled trial demonstrates that the integration of program to improve medical adherence and Thai- intelligent pill box improved medical adherence among Thai elderly hypertension patients in rural area.